Minimally invasive surgical procedures are typically conducted through one or more small ports that are inserted through relatively small incisions. Laparoscopic surgery, for example, may involve infusing a gas into a portion of the patient through a small port to facilitate visual access and operating space within the patient. Surgeons may perform various procedures laparoscopically where bodily structures must be separated or retracted from surrounding tissue. Although the insufflation gas expands the abdomen to permit the surgeon to view the surgical site, it is often necessary to manipulate the internal organs or tissues to provide a clear path to the surgical objective. Conventionally, small, thin, long instruments are used to perform surgery and retract tissue structures, vessels, and organs. Such devices are disclosed, for example, in U.S. Pat. No. 4,190,042 to Sinnreich, U.S. Pat. No. 4,654,028 to Suma, U.S. Pat. No. 4,744,363 to Hasson, U.S. Pat. No. 4,909,789 to Taguchi et al., U.S. Pat. No. 5,195,505 to Josefsen, U.S. Patent Application Publication No. US 2008/0154299 A1 to Livneh, and U.S. Patent Application Publication No. US 2008/0242939 A1 to Johnston.
One major challenge to employing laparoscopic surgical techniques is the ability to move all of the unrelated or non-involved tissue out of the surgical site to permit better physical and visual access to the target tissue or organ. In an open procedure, large metal retractors are commonly used to pull the masses of small intestines away and then pack them off with surgical sponges. A dedicated separation of adjacent tissue structures is often desirable but can be technically difficult due to the limits of instruments that must fit through the working ports.
When performing various laparoscopic colorectal surgical procedures, the surgeon often must manipulate the surgical instruments through a pile or collection of bowel to open up a sufficient arena in which to perform the necessary surgical steps. This is often complicated by the need to move through several quadrants of bowel and otherwise vary the retraction states of tissue over the course of the procedure. These challenges are further exacerbated when performing single port access surgery (SILS) where all of the access devices are clustered through in a single incision. For example, when multiple retraction devices are passed through a single abdomen position, triangulation of the direction of retraction can be very critical and challenging.
Thus, the need exists for devices that provide multiple selectively guidable retraction means that are inserted through a single access port.
The foregoing discussion is intended only to illustrate some of the shortcomings present in the field of the invention at the time, and should not be taken as a disavowal of claim scope.